Randomized Efficacy Trial of MySmileBuddy, a Family-centered Behavioral Intervention to Reduce Early Childhood Caries

MySmileBuddy 的随机功效试验，一种以家庭为中心的减少儿童早期龋齿的行为干预措施

• 批准号: 10473513
• 负责人: CAROL KUNZEL
• 金额: $ 68.91万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10473513
• 关键词: 5 year old; Academy; Address; Adoption; Affect; Age; American; Behavior; Behavior Therapy; Behavioral; Caregivers; Cariogenic Diet; Child; Childhood; Chronic Disease; Clinic; Community Health Aides; Consensus; Consumption; Counseling; Coupled; Dental; Dental Hygiene; Dental caries; Diet; Disease; Disease Management; Education; Enrollment; Ethnic Origin; Evaluation; Family; Goals; Health Educators; Hispanic; Hispanic Populations; Hygiene; Individual; Instruction; Intervention; Knowledge; Learning; Low income; Maintenance; Measures; Mediating; Mediator of activation protein; Medical; Minority; Motivation; New York City; Nutritionist; Operative Surgical Procedures; Oral health; Parents; Pathway interactions; Pediatric Dentistry; Pediatrics; Population; Preschool Child; Prevention; Preventive; Public Health; Race; Randomized; Randomized Controlled Trials; Research; Risk; Science; Scientist; Social support; Surface; System; Testing; Therapeutic; Tooth Diseases; Tooth structure; Toothpaste; Translating; Treatment Efficacy; United States; Universities; Water fluoridation; Work; base; community setting; community-level factor; design; dietary; disease natural history; early childhood; efficacy evaluation; efficacy trial; health disparity; health information technology; high risk; high risk population; improved; innovation; novel; payment; personalized care; programs; recruit; repaired; scale up; social; social disadvantage

ABSTRACT/ PROJECT SUMMARY Longstanding practice has treated early childhood caries (ECC) primarily through surgical dental repair, reinforced by current payment systems, an approach that does not address the natural history of the disease or the oral hygiene and dietary behaviors that mediate its occurrence. Professional consensus on the value of ECC disease management is emerging but behavioral strategies remain largely unstudied among Hispanic children in the United States. The long-term goal of the proposed study is to reduce oral health disparities and inform a paradigm shift from a focus on treatment to one that also embraces prevention. It is known that using fluoridated toothpaste twice daily and consumption of a low cariogenic diet has both preventive and therapeutic value. What is not known is how to best translate the adoption and maintenance of salutary behaviors to populations at greatest risk. The proposed randomized controlled trial will evaluate the efficacy of a family focused behavioral intervention, MySmileBuddy, to reduce ECC progression in high-risk Hispanic preschoolers. We propose to recruit and enroll 858 two to five year-old children, all with ECC, along with their caregiver from pediatric medical clinics in northern Manhattan, New York City. Specific Aims are: (1) to assess MySmileBuddy's efficacy (versus control) to decrease ECC progression (defined as positive change in number of decayed, missing, or filled teeth (∆dmft>0) or surfaces (∆dfs>0)) measured 12-months post-randomization (and assessed again 24-months post-randomization); (2) to assess MySmileBuddy's efficacy (versus control) to enhance adoption of twice daily fluoridated toothpaste use and consumption of a low cariogenic diet; and (3) to assess causal pathways through which MySmileBuddy influences twice daily fluoridated toothpaste use and consumption of a low cariogenic diet. The proposed research is innovative and represents a departure from the status quo by shifting focus from treatment to prevention, shifting education from verbal instructions and written materials provided by dental professionals to using interactive Health Information Technology delivered by Community Health Workers, and capitalizing on general pediatrics practices as a conduit for promoting children's oral health. At the completion of this study, we will know the extent to which MySmileBuddy promotes parents' acquisition and maintenance of oral hygiene and dietary behaviors that reduce ECC progression in a high-risk population of Hispanic preschool children. Ultimately, such knowledge has the potential to reduce the number of children needlessly affected by this preventable disease.

摘要/项目摘要 长期的实践已通过手术牙齿修复治疗了幼儿汽车（ECC）， 通过当前的支付系统加强，这种方法无法解决疾病的自然历史 或介导其发生的口腔卫生和饮食行为。关于价值的专业共识 ECC疾病管理正在出现，但行为策略在西班牙裔中基本上仍未被研究 美国的孩子。拟议研究的长期目标是减少口腔健康差异和 告知从关注治疗的范式转变，也可以接受预防。知道使用 每天两次氟化牙膏，而低蛋白酶饮食的消费既具有预防性和治疗 价值。尚不清楚的是如何最好地将有益行为的采用和维护转化为 人口危险很大。拟议的随机对照试验将评估家庭的效率 集中的行为干预，mysmilebuddy，以减少高风险西班牙裔的ECC发展 学龄前儿童。我们建议招募和注册858个两到五岁的孩子，以及他们的ECC以及他们的 来自纽约市曼哈顿北部儿科医疗诊所的护理人员。具体目的是：（1）评估 mysmilebuddy的效率（与对照）降低ECC的进展（定义为数量的积极变化 衰减，缺失或填充的牙齿（∆DMFT> 0）或表面（∆DFS> 0））在随机后12个月测量 （并在随机后再次评估24个月）； （2）评估Mysmilebuddy的效率（与对照） 为了增强每天两倍的氟化牙膏的使用和消耗低的肉源性饮食； （3） 评估因果途径，Mysmilebuddy每天都会影响两次氟化牙膏的使用和 消费低的致性饮食。拟议的研究具有创新性，代表了与 通过将重点从治疗转移到预防，将教育从口头指示转移到书面的状态 牙科专业人员提供的材料使用交互式健康信息技术提供 社区卫生工作者，并利用一般儿科实践作为促进的渠道 儿童口腔健康。这项研究完成后，我们将知道Mysmilebuddy的程度 促进父母对口腔卫生和饮食行为的获取和维持，以减少ECC 高风险的西班牙裔学龄前儿童的进展。最终，这样的知识具有 减少受这种可预防疾病所需的儿童人数的潜力。